TY - JOUR
T1 - Exit strategies for "needle fatigue" in multiple sclerosis: a propensity score-matched comparison study
AU - Prosperini, Luca
AU - Cortese, Antonio
AU - Lucchini, Matteo
AU - Boffa, Laura
AU - Borriello, Giovanna
AU - Buscarinu, Maria Chiara
AU - Capone, Fioravante
AU - Centonze, Diego
AU - De Fino, Chiara
AU - De Pascalis, Daniela
AU - Fantozzi, Roberta
AU - Ferraro, Elisabetta
AU - Filippi, Maria
AU - Galgani, Simonetta
AU - Gasperini, Claudio
AU - Haggiag, Shalom
AU - Landi, Doriana
AU - Marfia, Girolama
AU - Mataluni, Giorgia
AU - Millefiorini, Enrico
AU - Mirabella, Massimiliano
AU - Monteleone, Fabrizia
AU - Nociti, Viviana
AU - Pontecorvo, Simona
AU - Romano, Silvia
AU - Ruggieri, Serena
AU - Salvetti, Marco
AU - Tortorella, Carla
AU - Zannino, Silvana
AU - Di Battista, Giancarlo
N1 - J2: J Neurol
M1 - Journal Article
PY - 2019
Y1 - 2019
N2 - Patients with multiple sclerosis on long-term injectable therapies may suffer from the so-called "needle fatigue", i.e., a waning commitment to continue with the prescribed injectable treatment. Therefore, alternative treatment strategies to enhance patients' adherence are warranted. In this independent, multicentre post-marketing study, we sought to directly compare switching to either teriflunomide (TFN), dimethyl fumarate (DMF), or pegylated interferon (PEG) on treatment persistence and time to first relapse over a 12-month follow-up. We analyzed a total of 621 patients who were free of relapses and gadolinium-enhancing lesions in the year prior to switching to DMF (n = 265), TFN (n = 160), or PEG (n = 196). Time to discontinuation and time to first relapse were explored in the whole population by Cox regression models adjusted for baseline variables and after a 1:1:1 ratio propensity score (PS)-based matching procedure. Treatment discontinuation was more frequent after switching to PEG (28.6%) than DMF (14.7%; hazard ratio HR] = 0.25, p 
AB - Patients with multiple sclerosis on long-term injectable therapies may suffer from the so-called "needle fatigue", i.e., a waning commitment to continue with the prescribed injectable treatment. Therefore, alternative treatment strategies to enhance patients' adherence are warranted. In this independent, multicentre post-marketing study, we sought to directly compare switching to either teriflunomide (TFN), dimethyl fumarate (DMF), or pegylated interferon (PEG) on treatment persistence and time to first relapse over a 12-month follow-up. We analyzed a total of 621 patients who were free of relapses and gadolinium-enhancing lesions in the year prior to switching to DMF (n = 265), TFN (n = 160), or PEG (n = 196). Time to discontinuation and time to first relapse were explored in the whole population by Cox regression models adjusted for baseline variables and after a 1:1:1 ratio propensity score (PS)-based matching procedure. Treatment discontinuation was more frequent after switching to PEG (28.6%) than DMF (14.7%; hazard ratio HR] = 0.25, p 
KW - Multiple sclerosis
KW - Needle fatigue
KW - Oral drugs
KW - Treatment persistence
U2 - 10.1007/s00415-019-09625-1
DO - 10.1007/s00415-019-09625-1
M3 - Articolo
SP - 10.1007/s00415-019-09625-1
JO - Journal of Neurology
JF - Journal of Neurology
SN - 0340-5354
ER -